Renal coma - Causes, Symptoms and Treatment .MF .
Renal or uremic coma - this is an extremely serious condition that occurs due to renal failure and manifested a deep unconsciousness.
reasons renal coma
immediate cause renal coma is acute or chronic renal failure.In this disease of human kidneys begin to filter urine and bad because of all pathological metabolic products are not derived from blood, and it continues to circulate.Urea and creatinine, which are those most pathological products entering the brain, leading to a disorder of thought and consciousness, and for longer stays there and does, cause loss of consciousness with a partial disorder of blood circulation and respiration.But
renal failure - is the immediate cause of the coma.Causes same kidney failure can be many.The most common pathological processes which lead to renal disorder of consciousness genesis of renal diseases are chronic.Conditions such as pyelonephritis and glomerulonephritis, characterized by inflammation of kidney tissue may cause disorder of renal function and lead t
In addition, the problem may be hiding a bit lower when disrupted the flow of urine out of the bladder stones or prostate adenoma.This stagnation of urine in the bladder first, and then in the kidneys, leading to the destruction of the membranes in the kidney tubules, which ends with a direct hit of urine into the bloodstream.Such situations are quite rare, since before the start stagnation of urine in the kidneys, the patient will disturb the sharp pain in the pubic area with which he is sure to come to the doctor.
But when blockage occurs slightly higher at the outflow of urine from the kidney, such a situation is very real.The most common reason for this stagnation is the stone, although there are cases of blockage at this level of the tumor.Clinically it is manifested renal colic, which moves slowly in uremia.
also cause renal coma can serve a variety of poisoning, which lead to renal function disorder.The group includes benzenes renal toxins, lead, and others.
Symptoms of renal coma
By definition it becomes clear that renal coma should be shown the absence of consciousness.However, you must remember that just before the coma, there is a period of time when a person from a state of clear consciousness begins to "load".During this time, there is, so-called, uremia , which is very important to diagnose in order to prevent the man to fall into a coma.
during uremia patient complaints start to disturb the brain.It manifests confusion, persistent dizziness, state of arousal or, conversely, depression.Casual man without medical training, to see such a patient, said that he simply raves.Basically, the way it is.The only thing that may be in a similar situation to point out the presence of uremia - a smell of urine from the company .Typically, in these patients, he feels quite distinctly, so that does not even have to incline close to the patient to feel the smell.
Directly behind uremia occurs renal coma .Against the backdrop of all these complaints a person begins to lose consciousness slowly.As a rule, the majority of medical examinations of these patients falls on the state of coma.In this state, it is important to determine whether the person is alive and find out the cause of this condition.To help with the cause may be the same smell of urine from the company, which only increases with worsening conditions.
evidence that the person is in a coma, not dead, is the presence in it of spontaneous breathing and pulse on carotid and radial artery as well as the presence of reflections from the cornea.The latter can be very easy to check if you touch any object or to the open eye.In the case of coma patient necessarily react constriction of the pupil.
Diagnostics uremic coma
entire list of diagnostic procedures during renal coma aims to determine the severity of the patient's condition and find out the direct cause of the disease.To determine the severity of the patient had taken blood for blood count and measure the amount of urea and creatinine last.The level of these two substances in human blood, and can send the correct medical treatment.
To determine the root cause of the disease may need a lot more research.First performed renal ultrasound and radiography of the pelvic organs.In these two studies can determine the presence of stones in the bladder or kidneys.In addition, ultrasound gives the doctor a clear view of the state of renal tissue.In more complex cases, you can carry out a CT scan of the abdomen and pelvis.
ultrasound kidney stones
addition, determined the level of electrolytes in the blood in order to control the amount of fluid therapy to be carried out to the patient.
Treatment of renal coma
uremic coma Treatment can be divided into drug and hardware.As to the first, in this situation it is carried out by intravenous infusion of large amounts of liquid.For this purpose are used solutions of glucose or sodium chloride, which is a medical language called saline.Once the vein introduce a certain amount of dilution fluid exchange product available there, diuretics are used to contribute to the removal of most of the products of the organism.For this purpose, apply such powerful diuretics like Lasix or furosemide.In principle, these drugs can be bought yourself at the pharmacy, but this makes no sense, as they are introduced only in the vein and in the hospital.
For further infusion therapy drugs used to prevent blood clotting.This group includes all known heparin, it is administered subcutaneously in conditions of inpatient treatment.
In the most severe cases, hormones are used.This group includes drugs such as prednisolone and dexamethasone.
As for hardware treatment, it can be used as a treatment for renal coma and to eliminate its root causes.For example, if the coma caused by a stone or tumor, in such a situation simply can not do without surgery.If the outflow of urine prevents enlarged prostate, then in such a situation it is necessary to introduce into the cavity of the bladder urethral catheter that instantly relieve symptoms of acute urinary retention.
In a situation where a conservative pull all the toxins from human blood can not be necessary to use methods such as plasmapheresis or hemodialysis.At the same time the patient is connected to a special machine, which, passing through itself human blood, cleans it from a variety of toxins and abnormal metabolism products.
Apparatus for hemodialysis
Feeding habits and way of life in renal coma
The initial treatment of renal coma patient generally eats only through a dropper.Later he is allowed to use a small amount of low-fat foods in the same small amount of water.After renal coma should be excluded from the diet of those products that contribute to the formation of ammonia in the body.Most often are proteins that are found in food products such as meat and beans.
rehabilitation after illness
Rehabilitation after renal coma should be focused on prevention and treatment of the underlying causes of the disease.For example, if loss of consciousness caused by occlusion episode was outflow of urine calculi, the patient in need of surgery to remove these pathological agents.This same situation is observed in the presence of urinary tract tumors.
If the cause of renal coma was poisoning by certain substances, then in the future you should try to avoid repeat episodes and no longer in contact with such substances.
renal coma Treatment folk remedies
all cases when kidney who tried to treat people's means, are fatal.The fact that an unconscious person can not enter the drug by mouth, as if it will be possible to do with a nasogastric tube, the treatment is absolutely no results will not bring.
However, in relation to renal coma need to pay tribute to traditional healers, which in most cases is simply not taken treatment for this problem, relying on the bad experience of their predecessors.
Complications of renal coma
most severe complications of renal coma is necessary to consider the consequences of the nervous system that may occur after a person's way out of this state.Of course, people with disabilities do not remain, but most of these patients have quite serious consequences in terms of the nature of the disorder, thinking, memory, and other functions.To prevent such situations, you must consult your doctor as soon as the patient begins to experience symptoms associated with uremia.It must be remembered that such a problem as uremia and renal coma inheritance is not a urologist, and resuscitation. All patients with renal coma treated exclusively in the ICU .
Prevention renal coma
Prevention renal coma in the first place, should be directed to treatment of the underlying disease, which can lead to severe renal function disorder.For example, if the patient is aware of his chronic pyelonephritis or glomerulonephritis, then it is necessary to periodically consult with a urologist or nephrologist and periodically undergo diagnostic ultrasound of the kidneys.The same tactics should be, and in patients with prostate disease.
As for the other groups of causes uremic coma, poisoning, there is a need to be vigilant with regard to used products, as well as work place.The lion's share of poisoning falls on occupational hazards.In the case of determination at a food poisoning due to hazardous substances is an urgent need to carry out gastric lavage and go to the nearest hospital.Tactics prevention of uremia in this case - is the introduction of an antidote, a substance that is able to neutralize the poison in the blood.
Ed.urologist, sexologist-andrologist Plotnikov AN